Care Quality Commission fees consultation – have your say

Source: CQC

CQC have published a consultation document about the fees they propose to charge registered providers in 2019/20 and are inviting you to have your say.

CQC are required to consult widely on any proposed changes to the fees they charge will continue to give providers and their representatives the opportunity to review, comment upon and be able to plan for any changes that will affect them. The fees paid by providers enable CQC to fulfil its purpose of making sure health and social care services provide people with safe, effective, compassionate, high-quality care.

The consultation proposals follow the plans set out in previous consultations to meet the Treasury’s requirement to recover chargeable costs in full from providers. In 2015/16, CQC’s budget was agreed at £249 million. They spent £239 million and have continued to drive down costs so that their planned expenditure for 2019/20 is £217 million. This is a result of the controls exercised over spending and increased efficiency in inspections and other operational activity. CQC will continue to look carefully at costs, and to demonstrate that they are fair, efficient, effective and proportionate.

CQC are constantly refining their costing model to ensure they are better able to assess whether the fees they charge match the cost of regulation. Their assessments tell them that they need to rebalance the overall fees charged to ensure one sector does not subsidise the cost of them regulating another.

CQC’s proposals for the coming financial year reflect the move to a position to recover all costs for chargeable activities through fees, as well as a desire to address sectors where the need to adjust the cost of regulation and fees recovered has been identified. CQC are therefore making specific proposals for:

the community social care sector (which includes domiciliary care services), where they propose a fee increase, as the final year of the planned four-year trajectory to full chargeable cost recovery

the dental sector, where CQC propose a fee increase to better align against our costs

the residential social care sector, where they propose a fee decrease to better align against our costs

The following examples are based on calculations of an average provider in each sector and the proposed change to their fee:

CQC estimate that for community social care locations supporting up to 22 service users their fee increase would be no more than £144 per annum. This represents half of all locations

We are proposing that all providers will see the same flat percentage increase. Representing almost two-thirds of dental providers, single location dental practices with between one and three dental chairs would see their fee increase by no more than £97 per annum

The average residential social care provider with 26-30 beds at one location would see a fee reduction of £64 under the new proposals

Most NHS trusts and NHS GPs will see a small change to their fees from April 2019 because of the changes we made to their fees structure last year. This is because each provider’s fee is calculated by looking at their size against the total size of the sector, both of which change year-on-year. However, this will not alter the total fees collected overall for these sectors. Community social care providers will also be affected by the structural changes made last year, as well as the overall increase mentioned above.

CQC recognise the financial challenges that providers face, and do not underestimate the impact of fees on providers. They believe that their proposals for 2019/20 will rebalance fees across the sectors, while preventing fees from fluctuating unreasonably year on year. CQC also reflect strategic ambitions to continue to use data more effectively in assessing the costs of regulation.

Full details and descriptions of each proposal given in the consultation document and draft regulatory impact assessment.

When CQC have analysed the feedback from this consultation in January 2019, they will prepare a response and a final fees scheme. CQC’s Board will recommend the final fees scheme to the Secretary of State for Health and Social Care, whose consent is required in order for the scheme to come into effect. CQC expect to publish their response and final fees scheme in March 2019, for implementation on 1 April 2019.

You can find the consultation document and respond using their online form by clicking here. The consultation is open for responses until midday on 17 January 2019.